Do I Really Need A Tummy Tuck?

Do I really need a full tummy tuck? – Why not just liposuction or the “mini tuck?”

This is the number one question patients ask when they come in looking to get their pre-baby(s) body back. Most often, patients are hoping to only need some liposuction or a mini-tuck to address their concerns.

Liposuction is body-contouring procedure that reduces fat from under the skin through small stab incisions using small cannulas. It is used to address trouble spots throughout the body. The overall success of the procedure depends on the skin retracting back after the fat is reduced. The ideal candidates are young patients with good quality, elastic skin who are targeting stubborn areas resistant to diet and exercise.

A mini abdominoplasty (or mini-tuck) is a fine-tuning tummy-tuck that reduces a small amount of lax skin from below the belly button. It is tailored to a small subset of patients who have no abdominal wall laxity, no excess skin above the belly button, and only a small pouch of excess skin and fat below the belly button.

Unfortunately, most women have too much excess skin and laxity in their belly muscles to benefit from liposuction or a mini-tuck alone.

For these women, a typical full tummy tuck (full abdominoplasty) is offered to flatten and reduce excess skin and stretch marks from both above and below the belly button and tighten the abdominal muscles. The trade off, however, is a scar in the bikini line that extends hip to hip and a scar around the belly button.

How can I see what surgery may be right for me? – “The Mirror Test.”

An easy way to know if you need a full tummy tuck is to look for the following things while naked and standing in front of the mirror.

• From the front, do you have stretch marks around your belly button? When you pinch your skin, is it thick and snappy or is it thin and crepey?
• Front the side do you see skin that hangs, creating an extra fold(s) (perhaps you have to “tuck” this extra skin into your underwear or pants)? When you flex your belly muscles, does your belly still bulge?

If you answer “Yes!” to any of these questions, you will probably need a full tummy tuck.

What is a “FULL” tummy tuck?

The full tummy tuck (full abdominoplasty) operation is performed in an operating room under general anesthesia and begins with elevating a layer of belly skin and fat; separating it from the belly muscles all the way up to the ribs. During this dissection, the belly button is separated from the surround skin and left attached to the belly wall. The skin and fat is pulled down tight and the excess skin and fat is reduced. The abdominal muscles are then sutured together to reduce the laxity (plication). Finally, the belly button is brought out to the surface through a new hole in the skin (transposition) and the incisions are closed over drains.

How is recovery from a full tummy tuck?

As with any surgery, the pain after a full tummy tuck is usually worse in the 2-3 days immediately after surgery and tends to improve after that. Management of pain is usually through a combination of narcotic and non-narcotic pain medications taken by mouth, oral medications that lessen muscle spasm, and long acting local anesthetics injected during surgery or infused from a small pump.

Post-operatively, patients are placed into an abdominal binder with smoothing foam backing. Patients wear this until about a week after the drains are removed (usually around 3 weeks after surgery). Dr. Tauber then recommends patients transition to a Spanx OnCore Firm Control Open-Bust Bodysuit (available on Amazon) for smoothing compression for the next month.

The ability to return to work and everyday activities is variable and depends on many factors including the type of work, the pain tolerance of the patient, and the extent of the procedures. Most patients are ready to return to their lives in 2 weeks.

Read more about scar management on our blog post Post-Operative Care After Plastic Surgery.

What about my breasts?

Deflated, drooping breasts after childbearing and breast-feeding are a common complaint. These patients are offered a combination of a breast lift and / or augmentation with an abdominoplasty – coined a “mommy makeover.” Other combinations include abdominoplasty and liposuction and abdominoplasty and Brazilian Butt Lift (BBL). Dr. David Tauber at DeLuca Plastic Surgery tailors all of these operations to each individual patient.

Interested in combining breast and belly surgery? Read more about Mommy Makeover surgery.